Breath Holding Spells in Toddlers: What I Learned As a Parent and What Actually Works
The blue dinosaur lollipop was taped right at Lila’s eye level, the neon wrapper glinting like a secret. She grabbed it before I could move the cart, her chubby fingers crinkling the plastic, and when I told her we’d already had one treat that afternoon, her lower lip pushed out. Ten seconds later, she wasn’t crying. She just stopped breathing. Her face went from pink to brick red to a scary, dusky purple, and her body went limp against the side of the cart. The woman behind me gasped.
This was the third time that month. The first time, I was home alone washing dishes when I took a pair of kitchen scissors out of Lila’s hand. She stiffened, went purple, and slumped to the floor. I thought she was choking. I called 911 screaming, did what I thought was Heimlich, and by the time the ambulance pulled up to the house, she was sitting on the couch babbling, chewing on a teething toy. The ER doctor sighed (gently, not meanly) and said it was a breath holding spell. I’d never even heard of them. I left the hospital embarrassed, and still terrified it would happen again.
After that grocery store spell, I sat down with our pediatrician and picked her brain, then picked my sister’s—she’s a preschool teacher who deals with this a couple times a year in her classroom. What I learned ended up being way simpler and less scary than what I’d googled at 2 a.m.
First off: it’s not intentional. That’s the thing everyone gets wrong. I thought Lila was holding her breath to manipulate me into giving her what she wanted. But it’s an involuntary reflex. Kids’ nervous systems are still growing, and when they get overwhelmed by anger or frustration or fear, their body short-circuits. They just forget to start breathing again for a few seconds. Most of the time, it’s over in less than a minute, and they go back to normal. That doesn’t mean it’s not scary, it just means you don’t need to treat it like bad behavior upfront.
I made two big mistakes at the beginning that made the spells happen more often. The first time, after that 911 scare, I started bending the rules to avoid another episode. If she reached for a forbidden thing and I saw her lip start to tremble, I’d let her have it just to avoid a fit. That turned into spells twice a week, because even though the spell itself isn’t intentional, her brain quickly learned that getting really upset got her what she wanted. The second mistake was panicking. I’d hover, shake her a little, blow in her face as hard as I could, make a huge fuss the second it was over. All that extra stimulation just made her more overwhelmed, and the spells lasted longer.
What actually works is way calmer, and it’s the same whether you’re a parent at home or a teacher in a classroom. First, clear the space. If they’re standing near a coffee table, a curb, or a stack of heavy blocks, just move the hard, sharp stuff out of the way so they don’t hit their head if they slump over. That’s all you need to do for safety. Don’t pick them up unless they’re already falling—too much touching can overstimulate them and make the spell last longer.
Then, say one short, calm phrase and nothing else. I use “I’m here, you’re okay, I’m waiting for you.” I don’t yell, I don’t beg, I don’t coo at them for five minutes. Just that one line, in a normal voice, and then I wait. My sister does the same in her classroom: if it happens during circle time, she tells the other kids “they’re just fine, we’re waiting with them” and keeps the rest of the class moving a little so there’s no big crowd of kids staring. That keeps the whole thing low-stakes.
The hardest rule, especially when you’re in public and everyone’s staring: never give them what they were upset about after the spell. I know it’s tempting. The woman behind you in line is giving you the side eye, you just want it to be over, so you hand over the lollipop. But that just reinforces the cycle. After the spell passes, don’t make a big deal out of it either. Don’t spend 10 minutes cuddling them and cooing about how scared you were, and don’t scold them for scaring you. If they want a quick hug, give it, then just go back to whatever you were doing. Too much attention, good or bad, makes it more likely to happen again.
It’s also good to know when to check in with a doctor. If a spell lasts longer than two minutes, if it happens after your kid hits their head, if they don’t act completely normal right after it ends, or if they’re still having spells after age 5, get it looked at. Most of the time it’s just a harmless developmental quirk that kids grow out of, but it never hurts to rule out anything else.
Lila’s 3 now. She goes six weeks without a spell sometimes now, and when she does have one, it’s shorter than it used to be. Last week she had one at the park when I told her it was time to leave and she didn’t want to get out of the sandbox. She stiffened up, held her breath, I leaned against the play structure and waited. Ten seconds later she gasped, started crying a little, wiped her nose on my sleeve, and took my hand when I held it out. We got ice cream like we’d planned on the way home—that was already on our schedule, not a reward for the spell.
I still get that little lurch in my chest the second she stops breathing, old habit. I still get side-eye from strangers in the grocery store sometimes. But it’s gotten easier. I don’t panic anymore, I just wait. It’s just one of those messy, weird little things that comes with raising little kids, I think. It doesn’t mean you’re doing anything wrong, and it doesn’t mean your kid is bad. It just is. Most of the time, all you need to do is stay calm, clear the space, and wait. That’s it.
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